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There is currently no validated tool to measure the quality of life (QOL) in the Mongolian language. This study aimed to validate the Mongolian version of the World Health Organization Quality of Life – Brief (WHOQOL-BREF) questionnaire for the general population of Mongolia. The subjects were 301 adults aged 18–65 years selected randomly by a computer from 30 centers in 8 districts of Ulaanbaatar, Mongolia, in 2020. Reliability was measured using Cronbach’s α and intraclass correlation coefficients. Convergent, discriminant, and construct validities were examined using exploratory and confirmatory factor analyses for a four-domain factor structure. Among the participants, 56.1% were women, 32.9% held a bachelor’s degree or higher, 48.8% were employed, and 61.8% were married. The overall Cronbach’s α coefficient of the WHOQOL-BREF questionnaire was 0.804. Correlations between the component scores of the WHOQOL-BREF ranged from 0.581–0.822. All items showed higher item-total correlations with their corresponding domains than with other domains, except the mobility item from the physical domain. Discriminative validity was evident in physical and psychological domains. Exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 24 items that provided an acceptable fit to the data (RMSEA=0.084; CFI=0.860). In conclusion, the Mongolian version of the WHOQOL-BREF demonstrated evidence of good reliability and validity for assessing QOL in the general population of Mongolia. These findings indicate that it allows the comparison of QOL of adults in Mongolia with those in other countries.

The system to collect information on mortality statistics in Lao PDR is not well established, accurate and timely death information is therefore not available. This article reports the system and process to make the mortality statistical data of Lao PDR. The country has a paper-based resident registration system, using a death notification document, a death certificate, and a family census book. The death notification document is important as it provides the cause of death, which is issued from a health facility and the village office. In the event of a death occurring at home, the family representative needs to report to the village office verbally to obtain a death notification document. On the other hand, if the death occurred in a medical facility, a death notification document from a health facility is provided. The family representative should bring the death notification document to the district Home Affairs office to register the death and obtain a death certificate. After that, the family representative needs to bring the death certificate to the district Public Security office for an amendment in the family census book. ICD-10 is under development regarding death notification from health facilities under the Ministry of Health. However, it is unclear how death notification from village offices can adopt ICD-10 as the majority of deaths occur outside health facilities. A comprehensive and integrated mortality reporting system is necessary in order to create a holistic health policy and welfare for the country.

In Lao PDR, Ministry of Health introduced District Health Information Software 2 (DHIS2) in 2013. Although DHIS2 includes cause of death, Lao government did not request to report cause of death through DHIS2, resulting in no information on frequency of underlying cause of death even for the deaths at medical facility. This study aimed to collect the information on the underlying cause of death at all medical facilities in Xaiyabouli province, a rural area in Lao PDR. As well as the point estimate of the proportion, a 95% confidence interval (CI) based on a binomial distribution was calculated for each cause of death. According to the local government request, 226 deaths (128 males and 98 females) in 2019 were reported from all medical facilities in the province. Among them, infectious diseases were the most frequent (33.6%, 95% CI 27.5–40.2%); sepsis (16.8%, 95% CI 12.2–22.3%), pneumonia (8.8%, 95% CI 5.5–13.3%), and meningitis (4.9%, 95% CI 2.5–8.5%). Heart diseases were 15.9% (95% CI 11.4–21.4%) including heart failure and myocardial infarction. Injury was 10.2% (95% CI 6.2–14.4%) including brain injury. Neonatal death was 10.6% (95% CI 6.9–15.4%). Among those, preterm death was common (8.8%, 95% CI 5.3–13.3%). Renal failure was 8.0% (95% CI 4.8–12.3%). According to civil registration covering all deaths both at facilities and outside facilities, deaths at facilities were 16.8% of the whole deaths (1,372 deaths) in Xaiyabouli province. Although deaths outside facilities were not included, this is the first report demonstrating cause of death in one province in Lao PDR.

Although diagnosis and treatment of tuberculosis (TB) have been improved in many countries, delays in the diagnosis and treatment remain problematic in resource-limited countries. This study aimed to identify factors affecting delays in TB care in Mongolia. Data on TB cases registered from January 2016 to December 2017 were obtained from the national registry of TB at the Department of TB Surveillance and Research in National Center for Communicable Disease. The total number of TB cases registered in these two years was 8,166, including 3,267 cases of newly diagnosed pulmonary TB. Pulmonary TB cases (1,836 males and 1,431 females) were analyzed to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Patient delays longer than the median (28 days) were significantly associated with patient age >32 years (aOR=1.31, 95%CI: 1.14–1.51), residence in areas other than Ulaanbaatar (aimags) (aOR=1.38, 95%CI: 1.20–1.59), and smear-negative (aOR=0.57, 95%CI: 0.47–0.69). Health system delays longer than the median (7 days) were significantly associated with patient age >32 years (aOR=1.16, 95%CI: 1.00–1.33), residence in aimags (aOR=0.82, 95%CI: 0.71–0.95), special facilities including a prison hospital (aOR=4.40, 95%CI: 2.42–7.83), registration in 2017 relative to 2016 (aOR=0.83, 95%CI: 0.71–0.95), and smear-negative (aOR=1.72, 95%CI: 1.42–2.07). Total delays longer than the median (45 days) were significantly associated with patient age >32 years (aOR=1.39, 95%CI: 1.21–1.60), residence in aimags (aOR=1.27, 95%CI: 1.11–1.47), and smear-negative (aOR=0.74, 95%CI: 0.62–0.90). To shorten the total delay, improvement of the access to medical facilities in aimags is necessary.

As the aging population grows worldwide, the problem of age-related health is becoming an important public health concern. Dementia is a devastating disease that places a significant physical, emotional, and financial burden on patients, their caregivers, and society. It is predicted to increase in developing countries. The Revised Hasegawa’s Dementia Scale (HDS-R) has been used in many Asian countries to measure cognitive function. However, there is still no Vietnamese version of the HDS-R. Therefore, this paper describes the development of the HDS-R scale and manual in Vietnamese language. Two Vietnamese researchers translated the HDS-R from English to Vietnamese. To confirm the accuracy of the translation, two other Vietnamese researchers conducted a back-translation. Another pair of Vietnamese researchers compared the back-translated English version to the original one. All six researchers discussed the inconsistencies between English HDS-R scale and manual and derived the most suitable version for the Vietnamese context. In Questions 4 and Question 7, we changed the words from “cherry blossom” and “train” to “daisy flower” and “bicycle” for the first option, and from “plum blossom” to “rose” for the second option. We also changed the expressions in some places in the manual to fit the Vietnamese language. Future studies are needed to validate this version to be able to access cognitive function in both clinical and public healthcare settings.

Additional file 1. Short verbal autopsy form for adult deaths outside health facilities in Lao PDR.